Clinical Updates

3 December 2012

Novel coronavirus 2012: Kingdom of Saudi Arabia, Qatar and Jordan

On 28 November, a further fatal case of novel coronavirus 2012 from the Kingdom of Saudi Arabia was reported to World Health Organization (WHO). This case occurred in October 2012 and was from the same family cluster of two other previously confirmed cases [1].

On 30 November, two fatal cases of novel coronavirus 2012 from Jordan were confirmed to WHO. These cases were confirmed retrospectively, having been diagnosed with severe pneumonia in April 2012. At that time, no specific tests were available for novel coronavirus 2012 [1].

These cases bring the total of laboratory confirmed cases to nine; five cases (including three deaths) from Saudi Arabia, two cases from Qatar and two cases (both fatal) from Jordan.

Coronaviruses are causes of the common cold but can also cause more serious illness including Severe Acute Respiratory Syndrome (SARS). The novel coronavirus 2012 is different to any coronavirus previously identified. There is currently no evidence of sustained human-to-human transmission of this virus. Investigations are on-going to look into the likely source of infection and the route of exposure for those cases detailed above. Close contacts of these cases are being identified and followed-up [2-3].

Advice for travellers

The risk of novel coronavirus 2012 infection to UK residents travelling to the Middle East remains very low.

There is no change to travel advice; there are no travel restrictions and no specific advice for travellers to the Middle East.

Travellers returning from the Middle East with mild respiratory symptoms are most likely to have a common respiratory illness such as a cold.

However, if symptoms worsen considerably, medical advice should be sought from the GP or NHS Direct. Returning travellers should mention which countries of the Middle East they have visited.

Advice for health professionals

Health Professionals should, as always, take a detailed travel history when evaluating an ill returned traveller.

The Health Protection Agency has developed advice for health professionals in relation to novel coronavirus 2012, including a case definition for investigation and management of patients, and infection control advice. Where patients meet the possible case definition, clinicians should inform their local Health Protection Unit, which will be able to assist in the risk assessment and advise on what samples should be taken.

Standard transmission based precautions for respiratory tract infections should be instituted if a possible case is suspected.

Clinical queries about the management of potential cases of severe respiratory infections in people who have recently visited Saudi Arabia, Qatar or Jordan, or the neighbouring countries of Bahrain, Iraq, Israel, Kuwait, Lebanon, Oman, Syria, UAE and Yemen, should be directed in the first instance to the local infectious disease physician or microbiologists. The national Imported Fever Service is available to local infectious disease physicians or microbiologists should specialist advice be needed - tel – 0844 7788990.